Development and validation of a dementia risk score in the UK Biobank and Whitehall II cohorts
Background Current dementia risk scores have had limited success in consistently identifying at-risk individuals across different ages and geographical locations.Objective We aimed to develop and validate a novel dementia risk score for a midlife UK population, using two cohorts: the UK Biobank, and...
| Main Authors: | , , , , , , , , , , , |
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| Format: | Article |
| Language: | English |
| Published: |
BMJ Publishing Group
2023-10-01
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| Series: | BMJ Mental Health |
| Online Access: | https://ebmh.bmj.com/content/26/1/e300719.full |
| _version_ | 1827392032287490048 |
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| author | Mika Kivimäki Archana Singh-Manoux Georgios Georgiopoulos James H Cole Anya Topiwala Danielle Newby Melis Anatürk Raihaan Patel Klaus P. Ebmeier Ann-Marie G de Lange Michelle G Jansen Sana Suri |
| author_facet | Mika Kivimäki Archana Singh-Manoux Georgios Georgiopoulos James H Cole Anya Topiwala Danielle Newby Melis Anatürk Raihaan Patel Klaus P. Ebmeier Ann-Marie G de Lange Michelle G Jansen Sana Suri |
| author_sort | Mika Kivimäki |
| collection | DOAJ |
| description | Background Current dementia risk scores have had limited success in consistently identifying at-risk individuals across different ages and geographical locations.Objective We aimed to develop and validate a novel dementia risk score for a midlife UK population, using two cohorts: the UK Biobank, and UK Whitehall II study.Methods We divided the UK Biobank cohort into a training (n=176 611, 80%) and test sample (n=44 151, 20%) and used the Whitehall II cohort (n=2934) for external validation. We used the Cox LASSO regression to select the strongest predictors of incident dementia from 28 candidate predictors and then developed the risk score using competing risk regression.Findings Our risk score, termed the UK Biobank Dementia Risk Score (UKBDRS), consisted of age, education, parental history of dementia, material deprivation, a history of diabetes, stroke, depression, hypertension, high cholesterol, household occupancy, and sex. The score had a strong discrimination accuracy in the UK Biobank test sample (area under the curve (AUC) 0.8, 95% CI 0.78 to 0.82) and in the Whitehall cohort (AUC 0.77, 95% CI 0.72 to 0.81). The UKBDRS also significantly outperformed three other widely used dementia risk scores originally developed in cohorts in Australia (the Australian National University Alzheimer’s Disease Risk Index), Finland (the Cardiovascular Risk Factors, Ageing, and Dementia score), and the UK (Dementia Risk Score).Clinical implications Our risk score represents an easy-to-use tool to identify individuals at risk for dementia in the UK. Further research is required to determine the validity of this score in other populations. |
| first_indexed | 2024-03-08T17:24:04Z |
| format | Article |
| id | doaj.art-d5b7f0cd8e1d408aa983b8c3476ff0e2 |
| institution | Directory Open Access Journal |
| issn | 2755-9734 |
| language | English |
| last_indexed | 2024-03-08T17:24:04Z |
| publishDate | 2023-10-01 |
| publisher | BMJ Publishing Group |
| record_format | Article |
| series | BMJ Mental Health |
| spelling | doaj.art-d5b7f0cd8e1d408aa983b8c3476ff0e22024-01-03T01:00:08ZengBMJ Publishing GroupBMJ Mental Health2755-97342023-10-0126110.1136/bmjment-2023-300719Development and validation of a dementia risk score in the UK Biobank and Whitehall II cohortsMika Kivimäki0Archana Singh-Manoux1Georgios Georgiopoulos2James H Cole3Anya Topiwala4Danielle Newby5Melis Anatürk6Raihaan Patel7Klaus P. Ebmeier8Ann-Marie G de Lange9Michelle G Jansen10Sana Suri1111 Faculty of Brain Sciences, University College London, London, UK10 Inserm U1153, Epidemiology of Ageing and Neurodegenerative diseases, Université Paris Cité, Paris, France4 School of Biomedical Engineering and Imaging Sciences, King`s College London, London, UK1 Centre for Medical Image Computing, Department of Computer Science, University College London, London, UK2 Department of Psychiatry, University of Oxford, Oxford, UK2 Department of Psychiatry, University of Oxford, Oxford, UK2 Department of Psychiatry, University of Oxford, Oxford, UK2 Department of Psychiatry, University of Oxford, Oxford, UK2 Department of Psychiatry, University of Oxford, Oxford, UK2 Department of Psychiatry, University of Oxford, Oxford, UK9 Donders Centre for Cognition, Donders Institute for Brain, Cognition and Behaviour, Radboud Universiteit, Nijmegen, The Netherlands2 Department of Psychiatry, University of Oxford, Oxford, UKBackground Current dementia risk scores have had limited success in consistently identifying at-risk individuals across different ages and geographical locations.Objective We aimed to develop and validate a novel dementia risk score for a midlife UK population, using two cohorts: the UK Biobank, and UK Whitehall II study.Methods We divided the UK Biobank cohort into a training (n=176 611, 80%) and test sample (n=44 151, 20%) and used the Whitehall II cohort (n=2934) for external validation. We used the Cox LASSO regression to select the strongest predictors of incident dementia from 28 candidate predictors and then developed the risk score using competing risk regression.Findings Our risk score, termed the UK Biobank Dementia Risk Score (UKBDRS), consisted of age, education, parental history of dementia, material deprivation, a history of diabetes, stroke, depression, hypertension, high cholesterol, household occupancy, and sex. The score had a strong discrimination accuracy in the UK Biobank test sample (area under the curve (AUC) 0.8, 95% CI 0.78 to 0.82) and in the Whitehall cohort (AUC 0.77, 95% CI 0.72 to 0.81). The UKBDRS also significantly outperformed three other widely used dementia risk scores originally developed in cohorts in Australia (the Australian National University Alzheimer’s Disease Risk Index), Finland (the Cardiovascular Risk Factors, Ageing, and Dementia score), and the UK (Dementia Risk Score).Clinical implications Our risk score represents an easy-to-use tool to identify individuals at risk for dementia in the UK. Further research is required to determine the validity of this score in other populations.https://ebmh.bmj.com/content/26/1/e300719.full |
| spellingShingle | Mika Kivimäki Archana Singh-Manoux Georgios Georgiopoulos James H Cole Anya Topiwala Danielle Newby Melis Anatürk Raihaan Patel Klaus P. Ebmeier Ann-Marie G de Lange Michelle G Jansen Sana Suri Development and validation of a dementia risk score in the UK Biobank and Whitehall II cohorts BMJ Mental Health |
| title | Development and validation of a dementia risk score in the UK Biobank and Whitehall II cohorts |
| title_full | Development and validation of a dementia risk score in the UK Biobank and Whitehall II cohorts |
| title_fullStr | Development and validation of a dementia risk score in the UK Biobank and Whitehall II cohorts |
| title_full_unstemmed | Development and validation of a dementia risk score in the UK Biobank and Whitehall II cohorts |
| title_short | Development and validation of a dementia risk score in the UK Biobank and Whitehall II cohorts |
| title_sort | development and validation of a dementia risk score in the uk biobank and whitehall ii cohorts |
| url | https://ebmh.bmj.com/content/26/1/e300719.full |
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